IRON CHELATION IN 1998

Chronic transfusion regimens lead inevitably to iron overload, causing progressive organ dysfunctions and limiting life expectancy, so that iron chelation is needed in multiple-transfused patients to reduce iro n accumulation and toxicity. Desferal(R) is still the most used and th e most efficacious chelator. It must be, however, administered through subcutaneous infusion over 8-12 hours. Difficulties with compliance h ave prompted an ongoing search for alternatives, and in particular for molecules active after oral administration. The only drug available t oday is L1. This drug is less active than Desferal(R), and is responsi ble for rare agranulocytosis. Its indications are still to be discusse d. (C) 1998 Elsevier, Paris.